Please - would you put your daughter on Ritalin for ADHD for these reasons?

[SnowSpot]

Any advice at all, especially if you have gone through this dilemma, and I would be grateful.

I have a lovely, kind DD age 9. We moved to the States three years ago and she is now 'failing' her grade at school.

DD is a really nice girl. Her teachers have always said she is a joy to have in the class as she is so 'good'. But they also say she is really daydreamy and can't seem to keep focused on work. Increasingly, the pace of maths especially is speeding up, and she just can't seem to cope - even with 'extra support' at school and me trying to help her too.

Homework is especially a nightmare. She is incredibly distractible. Her younger brother can be a scamp about homework, but he grasps ideas pretty fast and gets stuff done. My DD can't seem to finish things, is very 'foggy' about understanding things. We sometimes both end up either frustrated or in tears. It's as if she doesn't have the energy to even try.

She is a bit of a space cadet - forgetful, and frequently seems behind in conversations. Because she is sweet, she is well liked, but I've noticed that she can't keep up with the 'banter' of her friends and is often silent. (I am a guide leader at her pack, so have seen this. I've never mentioned it to her though)

Because of the problems at school, I went to the GP for a educational referral (the school said this was the best way of accessing help). She has now been diagnosed with ADD - the attention deficit only.

They are recommending Concerta - saying she would be much more alert and that the 'fog' that seems to surround her would lift. Of course, we talked about side effects and these freaked me out.

I truly can't decide whether I should just throw everything in to having her tutored, say, and really trying to work with the school - or do that plan and also begin her on medication.

I don't really know what to do - I always found schoolwork easy, (like my son) and I suck as a teacher, so guiding her through homework is leading to stress for both of us.

I don't want a perfect child, but at the same time, sometimes the 'fogginess' of her behaviour and her blankness can be hard to cope with.

If you have any experience of this, I'd really appreciate your advice/story.
Thank you.

I have 2 sons, one has adhd the other add (amongst other things) my adhd son has had medication since starting school, he would have been unteachable otherwise. He had made it all through primary now and is doing well considering his quite extreme difficulties. My older son is like your daughter, he struggled for a long time before making the decision age 12 he would like to try medication in school time only. He feels it helps him a lot and tells me he can tell the difference if he occasionally forgets to take it. After a difficult few years he is finally making some progress.
I think your daughter is old enough to be able to trial it and give you feedback on how it feels to her. In my experience they start on a low dose until they get the level right.
It's a controversial subject for many but our family life and their education would have been in a very bad place without it.

The biggest drawback for us is loss of appetite, I have to make sure they eat well prior to taking it and it also can disrupt sleep if taken too late in the day. We have a 3.30pm cut off.

HTH

Thank you Themighty. That is exactly the kind of post I was wanting.

I'm frightened of the side effects - loss of appetite, ?growth problems, headaches, sleeplessness etc. She's a healthy kid who eats well, enjoys sports (although is quite clumsy) and I would hate to muck up her health.
Also, I'm just plain frightened of medicating a kid who might just be a daydreamer who is perhaps struggling with below-average intelligence…

I'm also afraid that if she falls back at school any more then she may have to repeat the grade - which would be just devastating for her seeing as she already had to leave her school in England 3 years ago (which gutted her).

Your response helps. Thank you.

You mention she is clumsy, my add son was recently dx as having dyspraxia too. This was flagged up because of joint pain he was having, he is hypermobile and on the back of this has had some useful sessions with an occupational therapist. Perhaps this is something to look into.

I understand your worry about side effects, I still worry but for us the alternative is worse. It does affect appetite and sleep which is why I'm strict about eating first and not giving it past late afternoon. My add son only has one slow release capsule before school anyway as he doesn't really need it weekends and holidays. I might reassess this when he needs to study for GCSEs though.
I think the height thing is a bit of a red herring, my younger son with Adhd is small but he has always been, personally I think that is more due to his condition that the medication he takes or maybe just genetics. It has made no difference to the height or weight of my older boy.
They do get headaches and stomach aches sometimes if it's taken on an empty stomach which is why I'm strict about food routine.
You can always trial it and see how it goes, nothing is set in stone so you can stop it at any time. The biggest difference for my older son is his increased confidence at school knowing he can participate better and get more done (he is another staring into space type).

Also I suspect your daughter is not low intelligence at all. My eldest was always in the bottom groups but since his medication and additional support from school (extra time, a scribe in exams) his grades have increased a fair bit. He can articulate very well verbally.

Thanks Themighty (sorry, just woken up to see these!)

You are right about trialling it perhaps. I'm going to chat with her teachers and ask for an educational assessment, just to check that, say, it's not undiagnosed dyslexia or something first.

You've reassured me about the side effects - I guess everything has a side effect, so it's just managing it.

Did you find that the diagnosis though was quite subjective? It seems to rely on a questionnaire that I fill out. What worries me is that, what if I am too hard on her? (For example, I think my kids table manners are horrible, but AMerican parents often comment on how well behaved my kids are at the table). It worries me that simply on MY opinion, that a diagnosis can be made...

It's a difficult call I agree as there is currently no physical test for it. It's obvious with my younger son because he is very hyperactive but my older son isn't. Hence why his diagnosis was years later than his brother. It also seems to me that many conditions have a crossover of symptoms adhd, asd, dyspraxia etc...all have similarities with each other.
I tied myself in knots thinking about this for a good number of years before deciding if the medication was improving their lives and educational attainments I wasn't going to get too hung up on the exact diagnosis.

Best of luck getting help for your daughter, if you have any questions in the future pm me and I'm happy to chat .

My son had a diagnosis of ADHD with the highest component being attention deficit before his ASD diagnosis. He went onto Concerta morning dose only, mondays to fridays in term time for two years when he was eight.
The benefits really outweighed the disadvantages IMO. It was like a light a lightbulb being switched on for him. He was present, formed better relationships, had improved self confidence and trusted his own ability to do school work.
The teachers said it was like meeting our son for the first time.
So, everything was better.
He experienced very few side effects - no weight loss, no more problems sleeping than before.
So, my advice would also be to try it and see.

I'm almost in tears at how sweet you are both being MerdeAlor, and TheMighty.
You must know how this feels to be worried you are 'chemically coshing' your lovely DC, so what you have written is reassuring.

You struck a chord with me, MerdeAlor, in that I sometimes feel as though because of the fog my DD often seems to be in, I don't really feel as though I've 'met' my DD. She often won't give opinions because she can't seem bothered/it's too much like hard work to talk. I think that is why she is a 'joy to have in the class' - because she just doesn't cause a fuss or speak so she's no trouble. But I'd love to see the sparky side of her I occasionally glimpse. She doesn't ever really seem to be 'present' like my son is.

Thank you for the invitation to PM you TheMighty - I really appreciate it.

You're DD sounds very much like my 12yr old son. He has v recently been DX with ASD. His main issues are to do with executive functioning, which really harms school work, and social issues, which are really mild, but enough that he struggles to keep friends.
The fog you describe is where he lives! He has v high IQ, but it's a bit waisted in some ways because he just won't apply himself.
What you say about medication has me wondering if it would help him at all.... We are a little desperate for him just now.

I guess if you try it you could always stop? It's also worth knowing that aspergers (ASD) is often misDXd in girls.... Might be worth looking into (the questionnaires online aren't too bad f you're careful!

All the best...

I hope things get a bit less desperate for you and your DS Greengoose, it sounds a good thing that you at least have a diagnosis now, so I guess that is something to work on...

You are right, I think we might give it a try and stop it if it doesn't agree with her (the medication that is).

Socially, DD is quite 'popular' in that she has lots of nice quiet friends. So I'm not sure if it's ASD. She can't keep up with the more 'sparky' girls, she is a good listener though, in the sense that she has a very kind heart so is known as being the 'sweetie' of the group. I think it doesn't hurt that she is really quite pretty, which sounds like a superficial thing to say, but as someone who was a fairly gawky looking child, I've seen my DD accepted in ways that she doesn't seem to have to fight for. I guess that is the way of the better looking amongst us!

SnowSpot and Greengoose - I have a 10yo DS with Aspergers who has very recently also been diagnosed with ADHD Inattentive - so basically ADD, but the paed diagnosing him told us that ADD doesn't formally 'exist' as a diagnosis here any more (we are in the UK).

His difficulties sound similar to your DC. He's happy, sociable, has a lovely group of (geeky) friends, does well academically but the attention deficit issues are becoming more and more of a problem. A space cadet, as SnowSpot describes! Easily distractible, struggles to focus/concentrate. DS describes it as being 'like the world goes blurry' when he struggles to concentrate and then by the time things swim into focus again he's missed out on half a lesson.

He was put on medikinet (so a different brand to Concerta/Ritalin but the same basic drug of methylphenidate) just over a month ago. I was really hoping for the kind of outcome that Merde describes, but sadly it wasn't to be. Sleep became an issue (never had been before) but the key thing was that the meds had no positive effect on the attention deficit difficulties at all. If anything his teacher felt he'd got worse, and his behaviour at home deteriorated as well. So following discussions with his paed we have now switched DS's medication to Strattera (atomoxetine) which is, as I understand it, the other kind of medication for treatment of ADHD/ADD (non-stimulant, but takes longer for positive effects to show i.e. a couple of months rather than a couple of weeks).

I am sorry I can't post a more positive view of methylphenidate but thought it was worth offering our experience for comparison. I guess in a nutshell what I'm trying to say is, it's worth trying it, but try not to expect it to be 'the answer' and be prepared to consider other medications/options if you need to. DH and I were both guilty, I think, of seeing methylphenidate as the magic solution to all DS's difficulties, and it was gutting when it became apparent that the magic solution really wasn't working at all.

Good luck to you and your lovely DC

Thanks Dietcoke, for taking the time to write.

Actually, yours is just the kind of story I'd like to hear, because I am a pessimist and so the idea that there is a 'magic' pill makes me more nervous than the idea that there may need to be some kind of trialling etc.

I'd better check with the doctor about what kind of pill exactly they are talking about so I can read up on it.

A long term experience here...

My DD1 was dx at 6 (inattentive type predominently although she was also quite flitty around too, for want of a different description) She couldn't concentrate or focus long enough to achieve anything! Very reluctantly we decided to trial meds (Ritalin)

For her it was a magic pill.. she was able to concentrate SO much better and the teachers found she was actually rather bright after all!

Regarding weight and growth.. she was already skinny because she had no interest in food (and was obsessive about the food she would eat) and the docs did keep an eye on her. She grew into a skinny older child, and skinny teenager and now she is an enviably skinny adult.. and 5 ft 10 so it certainly didn't stunt her growth!

She took Ritalin from ag 6 -14 then stopped at her request to try without. Decided to go BACK on it at 18 because she was still struggling to concentrate and A levels were looming. She has remained on it since (under adult services), and is now 22. She is in her final year of medicine and will be a doctor next year!!!

I have NO doubt that without her meds she woould not have been able to follow her dream of being a doctor. She is still very much ADD and is aware of how much more effort she has to put in because she has the attention span of a gnat unmedicated! She is also dyspraxic and dyslexic (I'm afraid we joke that if she ever accidentally kills a patient it will be via her spelling )

It's worth a trial, and trying it doesn't mean she is sentenced to it!

I have two daughters with ADHD and they sound far more extreme in their behaviours than yours. My eldest is uncontrollable when not medicated, literally cannot sit, stand still, eat, listen or function. She is on methylphenidate and the effect is miraculous. She is calmer and can concentrate on short tasks and survive the school day. Like others have said it does affect the appetite which does worry me but she could not go to school without it.

My other dd did not respond to the same medication. She is on strattera (atomoxetine) which makes her a bit drowsy and irritable but is 24 hour. Again the appetite is affected and she has gone quite skinny but is the tallest in her class!

From what you say I would not medicate your daughter if she is only a bit spacey. I saw a documentary about how medication is overused in the states and whole families are on various medications with spurious diagnoses.

For me medication was a last resort but my dds could not have remained in mainstream education without it.

I would medicate her. I have/had ADD and medication definitely made the difference between academic success and failure for me

Reading with interest.
My ds was diagnosed with a "constellation" of disorders between the ages of 6-8yrs - ADD, dyspraxia, dyslexia, Tourette's and OCD. Ds was offered medication at 8 yrs, we decided against it mainly because of the side effects. A friends son had lots of issues with side effects and it really put us off. We have always been aware that ds doesn't achieve his full potential but did well enough...now at 16 he is struggling with his gcse studies and are looking at trying medication.
He sounds so like your dd snow, a real daydreamer and gentle soul.

I hope things go well for you and your family

I don't think medication is for daydreamers and gentle souls.

2 of my 5 have ADHD plus dysraxia, dyslexia etc and are both on medication.

DS went onto ritalin at 8 yo and at 25 is still supposed to take it. You can tell the difference when he doesn't. He is over 6ft tall and built like a brick shithouse

DD went onto medikinet at 7. She was tested by an Ed Psych at school. We had always thought she was a bit slow but the tests showed she was off the scale bright. Yet her schoolwork would suggest she was very low ability. The paed said the difference between her potential and her output was so great that it justified medicating. School really noticed the difference.

The good thing about these meds is they wear off quickly. So if they don't work you can just stop with no side effects.

I hope this thread will be of use to you, Idefix. I've not read many things like this where the child just has ADD rather than ADHD. I think because the child isn't 'driving you crazy' by leaping off things and running around the room shouting, the ones who can't focus don't seem to immediately have a problem.

Jinga - I appreciate your comment and you have expressed exactly my fears. Would I be medicating a problem, or her personality? If it's the former, then okay, but the latter would be terrible. I don't want a 'super child' I just want a kid who can keep up socially and get 'C's at school.

Tallulah - This is what I'm wondering with my DD - that what she is 'able' to do feels foggy and unlocked. Part of me just wants to at least see whether medication would do 'something', even if she had horrible side effects and we think "whoa, ok, that didn't work".

Another bit of background. My DD has had one more year of schooling than any of her schoolmates as in England we start school earlier. So her falling really behind seems crazy.

Also, the daydreamy part is more like a 'blankness'. When I ask her what she is thinking about (and encourage her to tell me stories etc) she genuinely looks surprised and has always said "nothing". You can almost see it in her eyes that she doesn't look faraway but rather blank. She often says "whaaaa?" when you ask her a direct question, as if she has to pull herself back from the blankness and reset herself before starting to hear people.

I've just found out the medication would be called "Vyvanse".

How are you and your dd getting on Snow? One week into term and ds has two detentions for not bringing in correct books...
School has been in touch and have done some assessments, ds performs below average when hand writing tasks but above average when using a laptop...have said they will now allow him to use a laptop during his exams.
Still worried that he will zone out in the middle of an exam ;)
Now have appointment with the ed psych in a couple of weeks to explore other options.

I've recently been diagnosed with adhd at the age of 41 and have been on concerta xl for two months. I am definitely feeling the benefits, I can focus on tasks better and my dh and gp both say I am calmer and more present. I have had anxiety for several years, longer probably, and the lovely psych who diagnosed me said its almost inevitable.

Adhd wasn't even suspected for me because I am (factually, important to state rather than any brag) pretty academically bright and have a good degree from a Russell group uni and am a teacher. However, it has all been by the skin of my teeth and I have had major problems with organisation that I have usually just about been able to get around. I feel a calmer, happier more satisfying life where I can plan,do and enjoy things rather than be flitting around in my fuggy brain is just opening up.

And yet, I have the dilemma, similar to yours about what to do with my bright but disorganised, impulsive daughter...ring any bells? I so want to get her investigated and I wouldn't be averse at all to trying medication.

I'd give meds a go. My psych said that its pretty clear whether they work or not and if you've got the problem they work on then the side effects seem to be fewer and less severe. I've had none.

Sorry for rambling on. I'm relating to your story from both sides and wish you wisdom in deciding what to do. Not all kids with adhd behave as you'd expect and the differences meds make are most noticeable to the person taking them.

Oh and I still feel like myself on meds, just a calmer, happier version.

DD has ADHD, and I teach in a school with a very high number of diagnosed students, so I have seen the effects of meds both at home and in the classroom.

the BIG advantages of Dd being on meds is that she is able to focus and do well at school, and also she seems more 'with us' when on meds. With students I have taught, I can almost 100% tell if they have forgotten to take their meds that morning, because it can help so much to get them settled and ready for school.

The disadvantages are that there is quite a balancing act between the meds, and food and sleep. We also use melatonin at night to help DD sleep, and she wears a patch with slow release ritalin that she can pull off early in the day so she doesn't have a full 9 hour dose (whereas once a pill is taken, it's in the system).

You can trial the drug then decide otherwise - it isn't any kind of commitment. DD doesn't have her patch at weekends or during the school breaks. Although the drug is supposed to be out of her system each evening, we do notice that her appetite really takes off about a week into the school holidays. She eats almost nothing during the school day but often eats two dinners in the evenings, so be prepared to be a bit unconventional with food.

The first day we tried ritalin, we went to a museum and I noticed the difference immediately. DD has quite a high 'hyper' component and I can see the differences as the drug kicks in and she stops fidgeting. I also have an adult friend who takes ritalin. She was diagnosed as an adult and says that the first day she took it, 'the clouds parted' and her brain was able to function.

None of the possible prescribed drugs guarantee success, but for those that find it works, it can be an amazing improvement.